Efficacy of Dexmedetomidine mixed with Ropivacaine for adductor canal block combined with general anesthesia in patients undergoing arthroscopic knee surgery / 中国内镜杂志

ABSTRACT

Objective To observe the efficacy and safety of Dexmedetomidine mixed with Ropivacaine for adductor canal block combined with general anesthesia in patients undergoing arthroscopic knee surgery. Methods Ninety patients underwent elective unilateral arthroscopic knee surgery were randomly divided into three groups (n = 30 each): general anesthesia group (Group G), general anesthesia + Ropivacaine for adductor canal block group (Group G+R) and general anesthesia + Dexmedetomidine mixed with Ropivacaine for adductor canal block group (Group G+DR). After the end of anesthesia induction, ultrasound-guided adductor canal block was performed in G+R and G+DR groups. In G+R and G+DR groups, 20 ml of 0.375% Ropivacaine and 20 ml of 0.375% Ropivacaine mixed with 0.6 μg/kg Dexmedetomidine were injected, respectively. After the induction of general anesthesia, the i-gel laryngeal mask airway was inserted, and the patients were mechanically ventilated in the two groups. Anesthesia was maintained with Remifentanil 0.15 μg/(kg?min) and Propofol adjusted to maintain BIS between 45 and 55. The time for recovery of spontaneous breathing, emergence time, and time for removal of LMA were recorded. The VAS scores at rest, during active functional exercise (AFE) and continuous passive movement (CPM) were recorded at the following points: 1 h, 4 h, 8 h, 12 h and 24 h after surgery. And quadriceps strength was evaluated at the following points: preoperative evaluation, 1 h, 4 h, 8 h, 12 h and 24 h after surgery. The total consumption of rescue analgesics, complications associated with adductor canal block, and occurrence of adverse cardiovascular events, over-sedation and postoperative nausea and vomiting were also recorded. Results Compared with Group G and Group G+R, the time for recovery of spontaneous breathing, emergence time, and time for removal of LMA were significantly shorter (P < 0.01). Compared with Group G, the VAS scores at rest, during AFE and CPM at 1 h and 4 h after surgery and the total consumption of Flurbiprofen axetil in Group G+R, and the VAS scores at rest, during AFE and CPM at 1 h, 4 h, 8 h and 12 h after surgery and the total consumption of Flurbiprofen axetil in Group G+DR were lower (all P < 0.05). Compared with Group G+R, the VAS scores at rest, during AFE and CPM at 8 h and 12 h after surgery and the total consumption of Flurbiprofen axetil in Group G+DR were lower (P < 0.01). No significant differences were seen among three groups in the terms of quadriceps strength, Dezocine consumption and adverse reactions (P > 0.05). Conclusion 0.6 μg/kg Dexmedetomidine mixed with 0.375% Ropivacaine 20 ml can provide faster recovery from anesthesia and effectively improve postoperative analgesia without inducing obvious adverse reactions when used for adductor canal block combined with general anesthesia in patients undergoing arthroscopic knee surgery.